OBJECTIVES: Ankylosing Spondylitis (AS) is a progressive arthritic disease causing pain and severe physical impairments, negatively impacting health-related quality of life. Approximately 127,000 people are estimated to have AS in the UK. Our objective was to estimate the budget impact, over a 5-year period, from the UK National Health Service perspective, of using secukinumab alongside TNF-α inhibitors for adult AS patients with inadequate response to nonsteroidal anti-inflammatory drugs. Secukinumab, the first selective IL-17A inhibitor, is the first licensed alternative to TNF-α inhibitors for AS.
METHODS: A budget impact model was developed to compare total drug acquisition and administration costs with and without the introduction of secukinumab. Currently available biosimilar and brand versions of TNF-α inhibitors were included in the analysis.. UK population projections were obtained from the Office for National Statistics and published literature. Current and future market share projections were from NHiS data and Novartis UK internal forecasts. The licensed posology was used for all treatments. Drug and administration costs were from the British National Formulary, UK NHS Reference Costs and PSSRU. Efficacy of secukinumab was assumed to be equivalent to the TNF-α inhibitors, based on network meta-analyses. Therefore, direct and indirect disease-related costs were not included in the model.
RESULTS: At list price, the cumulative budget impact of introducing secukinumab is estimated to be savings of £5.0 million over a 2-year period, rising to £49.2 million over a 5-year period. Sensitivity analyses revealed that increased secukinumab uptake resulted in greater cost savings. A confidential patient access scheme is available to the UK NHS, further increasing potential savings.
CONCLUSIONS: Secukinumab is a cost-saving treatment option for AS. Its introduction has the potential to enable more UK patients to be treated for this irreversible condition, from a fixed healthcare budget.
